Critical care medicine
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Critical care medicine · Jun 1996
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComparative study of propofol versus midazolam in the sedation of critically ill patients: results of a prospective, randomized, multicenter trial.
To compare the effectiveness, characteristics, duration of action, hemodynamic and biochemical effects, and side effects of propofol and midazolam used for continuous intravenous sedation of ventilated critically ill patients. ⋯ In this population of critically ill patients, propofol is an effective and safe alternative for sedation, with some advantages, such as short duration of action and high effectiveness over the conventional regimen with benzodiazepines and opiates.
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Critical care medicine · Jun 1996
Randomized Controlled Trial Clinical Trial Retracted PublicationInfluence of long-term continuous intravenous administration of pentoxifylline on endothelial-related coagulation in critically ill patients.
To determine the influence of pentoxifylline on endothelial-associated coagulation. ⋯ Continuous intravenous administration of pentoxifylline for 5 days beneficially influenced the thrombomodulin/protein C/protein S system in both the trauma and septic patients.
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Critical care medicine · Jun 1996
Comparative StudyHand-held blood gas analyzer is accurate in the critical care setting.
To determine the accuracy of a new, portable battery-powered blood gas analyzer when used by nonlaboratory-trained clinicians in the critical care setting. ⋯ IRMA is accurate and reproducible when used in the clinical setting by nonlaboratory-trained individuals. Nonlaboratory-trained individuals can obtain laboratory results in the critical care setting comparable with the results obtained by trained laboratory technologists. Bedside laboratory testing decreases turnaround time compared with a near-patient laboratory.
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Critical care medicine · Jun 1996
Comparative StudyEvaluation of gas exchange, pulmonary compliance, and lung injury during total and partial liquid ventilation in the acute respiratory distress syndrome.
To investigate whether pulmonary compliance and gas exchange will be sustained during "total" perfluorocarbon liquid ventilation followed by "partial" perfluorocarbon liquid ventilation when compared with gas ventilation in the setting of the acute respiratory distress syndrome (ARDS). ⋯ In a model of severe ARDS, pulmonary gas exchange is improved during total followed by partial liquid ventilation. Pulmonary compliance is improved during total, but not during partial liquid ventilation. Total followed by partial liquid ventilation was associated with a reduction in alveolar hemorrhage, pulmonary edema, and lung inflammatory infiltration.
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Critical care medicine · Jun 1996
Breathing measurement reduces false-negative classification of tachypneic preextubation trial failures.
There is increased awareness of imposed work of breathing contributing to apparent ventilatory dependency. This study evaluates the impact of tachypnea as an indicator of ventilatory failure during a room air-5 cm H2O continuous positive airway pressure, spontaneous breathing, preextubation trial when associated with increased imposed work of breathing. ⋯ Tachypnea as a marker of respiratory distress is sensitive, but is not sufficiently specific to be used as a criterion in preextubation trials. Reliance on tachypnea as a preextubation trial failure criterion is likely to prolong intubation and ventilatory support for a large number of patients. Patient risks, determined by the extubation failures and reintubation rate, are the same.